Rapid Killers: Bacterial Meningitis and Sepsis

Recently the rapid death of a 23 yr old woman from sepsis which the media originally reported as bacterial meningitis has sparked lots of confusion between the two conditions.  Today we would like to specifically target the differences between meningitis and sepsis.  Here is some of the information available for meningitis on iTriage

Description

An inflammation of the meninges, or linings of the brain. The damage to the meninges can be due to a infection or an inflammatory condition. Infections can be caused by viruses, bacteria, or fungi. Viruses are the most common cause. If left untreated meningitis can be fatal. The infection can arise from an infection of the blood, or from an adjacent infection (ear infection, sinusitis, nasal infection).

Symptoms

Fever and chills, confusion, nausea and vomiting, sensitivity to light (photophobia), severe headache, stiff neck (meningismus).

Tests

A history and physical exam will be performed. Tests are done to determine the source of infection and to identify damage done by the infection. A lumbar puncture (spinal tap) is performed to evaluate the cerebrospinal fluid (CSF) and establish the diagnosis. CSF cultures, and antibody testing identify the exact cause.

Standard Workup

  • CBC
  • Chem 12
  • UA
  • CT Scan

Treatment

Intravenous antibiotics are used for bacterial meningitis. An antiviral medication (acyclovir) is administered if herpes is suspected. Treatment of secondary symptoms such as brain swelling or seizures will be done.

Both meningitis and sepsis are very serious infections. Patients with sepsis feel light headed from a drop in blood pressure and many times have confusion and vomiting. Meningitis is suspected if the patient experiences a severe headache. The headache initially is mild and becomes worse over time-sometimes rapidly within hours. Since the infection affects the covering of the brain and spinal cord (meninges) patients can become confused and have a stiff neck. Most serious cases of meningitis are caused by bacteria with Neisseria meningitides being one of the most deadly. N meningitides is also called meningococcus and can spread between individuals in close knit groups such as college students in dormitories, athletic teams or the military.  The meningococcus vaccine can protect patients from Neisseria meningitides and is recommended for the following people:

  • Certain high risk children from ages 2 through 10
  • Pre-teens/Adolescents: 11 through 18 year olds
  • College freshman living in a dormitory
  • Military recruits
  • Patients with a damaged spleen or without a spleen
  • Patients with a terminal complement deficiency
  • Microbiologist who is routinely exposed to Neisseria meningitidis
  • Patients traveling to or residing in countries in which the disease is common

Patients can have both meningitis and sepsis if the infection spreads from the brain to the blood stream. Any patient who believes they have meningitis needs to seek medical attention immediately.  Use iTriage to help locate the nearest medical provider.

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